RADIATION DERMATITIS

By Gary M. White, MD

The skin is red and inflamed, like a very bad sunburn. Radiation dermatitis


Clinical

Radiodermatitis (RD) may be acute or chronic. In the acute setting, the skin is red and inflamed, analogous to a bad sunburn. Chronic radio dermatitis occurs months to years later and is characterized by thickening and fibrosis of the skin. Telangiectasias, loss of hair, and hypo or hyperpigmentation may be seen. Malignancy may develop in chronic radiation dermatitis.

It has recently been noted to occur in a localized area in the chest after coronary angioplasty or other procedures where fluoroscopy and/or cineradiography is used [BJD 1999;141;150]. In this scenario, a localized area of fibrosis, telangiectasia, and poikiloderma develops 1-2 years after the exposure.

Treatment

With regard to acute RD, a topical steroid may be tried. The area should be monitored for the possibility of malignant change. For chronic RD, microneedle fractional radiofrequency treatment has been recommended [JAMA Derm 2017;153;478], as has pulsed-dye laser, fractional carbon dioxide laser and epidermal grafting [Semin Cut Med Surg;2015;34;42].

Additional Pictures

Telangiectasias may form after radiation therapy for breast cancer. Note patient also has a herpes outbreak.
Radiodermatitis or radiation dermatitis

Chronic changes years after radiation therapy of an infantile hemangioma. This treatment is no longer used.
Radiodermatitis or radiation dermatitis

Another case of telangiectasia formation in the port of treatment for breast cancer.
Radiodermatitis or radiation dermatitis Radiodermatitis or radiation dermatitis

This man had an aggressive neoplasm of the scalp excised and then the bed radiated. Fibrosis, telangiectasia, and a non-healing ulcer resulted.
Radiodermatitis or radiation dermatitis

Long-term changes of thickening and telangiectasias.
Radiodermatitis or radiation dermatitis

Radiodermatitis or radiation dermatitis Radiodermatitis or radiation dermatitis

The left breast is swollen, red, and inflamed.
Radiodermatitis or radiation dermatitis

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